The Impact of an Inpatient Nurse-Triggered Sepsis Alert on Antimicrobial Utilization.
A nurse-triggered sepsis alert called "Code Sepsis" was implemented for early recognition and management of sepsis. The researchers analyzed its impact on antimicrobial use and identified factors associated with infection as source of Code Sepsis. The medical records of hospitalized patients with Co...
| Publicado en: | Joint Commission Journal on Quality & Patient Safety Vol. 47; no. 3; pp. 157 - 165 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
Mar2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=148727020&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 148727020 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15537250 17W5 jtl: Joint Commission Journal on Quality & Patient Safety issn: 15537250 maglogo: N pubinfo: dt: Mar2021 vid: 47 iid: 3 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 148727020 148727020 148727020 10.1016/j.jcjq.2020.11.004 148727020 ppf: 157 ppct: 8 formats: tig: atl: The Impact of an Inpatient Nurse-Triggered Sepsis Alert on Antimicrobial Utilization. aug: au: Kang, Minji Torriani, Francesca J. Sell, Rebecca E. Wardi, Gabriel Abeles, Shira R. sug: subj: Sepsis Nursing Antiinfective Agents Nursing Interventions Early Diagnosis Human Logistic Regression Odds Ratio Descriptive Statistics Retrospective Design Data Analysis Software T-Tests Chi Square Test Male Female Adult Middle Age Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: A nurse-triggered sepsis alert called "Code Sepsis" was implemented for early recognition and management of sepsis. The researchers analyzed its impact on antimicrobial use and identified factors associated with infection as source of Code Sepsis. The medical records of hospitalized patients with Code Sepsis between January 1 and June 30, 2018, were reviewed. Patients were classified as " Infection" when probable or definitive infection was identified or "No Infection" when a probable or definitive noninfectious source was identified. Patients were categorized as " Escalation " with addition or change to broader-spectrum antimicrobials or " No Escalation " with no change or change to narrower-spectrum antimicrobials. Escalation was classified as " Indicated " with appropriate escalation or " Not Indicated " with inappropriate escalation. Logistic regression model was used to identify factors associated with Infection as Code Sepsis trigger. Code Sepsis was activated in 529 patients, with Escalation in 246 (46.5%) and No Escalation in 283 (53.5%) patients. Escalation was Indicated in 157 (63.8%) and Not Indicated in 89 (36.2%) patients. Infection was identified in 356 (67.3%) and No Infection in 173 (32.7%) patients. History of HIV (odds ratio [OR] = 2.75, p = 0.03), temperature > 38.3°C or < 36°C (OR = 2.63, p < 0.01), and respiratory rate > 20/minute (OR = 1.56, p = 0.02) were associated with Infection , while surgery within 3 days (OR = 0.30, p < 0.01) was associated with No Infection. One hospital system's Code Sepsis inadvertently identified patients without infections and led to antimicrobial overuse. By refocusing Code Sepsis on early recognition of severe sepsis and septic shock only, the organization hopes to optimize resource utilization and improve patient outcomes. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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